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Team Training & Competition Team Registration Form

TEAM REGISTRATION

Team registration fee: $950.00 (Eight maximum Team Members and one Team Trainer)

Registration is now open

A Team is defined as three to eight Team Members and one Team Trainer. Additional Team Trainers will need to register as Non-Competitors.
Team registration fee will include swag bag, Vendor Night (includes dinner), kick-off breakfast, Wednesday competition lunch, Thursday competition breakfast and lunch and Banquet (includes reception and dinner).

"*" indicates required fields

Step 1 of 6

16%

Team Name:*

Company Name:*

Company Address:*

Street Address City State / Province / Region ZIP / Postal Code

Which Rules Do You Wish Your Team To Be Judged By:*

National Rules

Regional Rules

Does Your Team Qualify for Novice Team?

Novice Teams (if requested) are defined as a team that is within the firsts 2 years of competing.

Yes

No

Team Contact Name:*

First Last

Team Contact Email :*

Team Contact Phone:*

Number of Members on Team*

(Minimum of 3 Team Members and Maximum is 8 Team Members.)

Team Members

A Team is defined as three to five Team Members and one Team Trainer. Additional Team Trainers will need to register as Non-Competitors.

Team Captain Name:*

First Last

(The Team Captain is the designated Team Member 1)

Team Captain Shirt Size:

Team Captain Glove Size:

Do you have a Team Trainer?*

No, we do not have a Team Trainer

Yes, we have a dedicated Team Trainer

Yes, we have a Team Trainer who serves as Team Captain too

Team Trainer Name:

First Last

Team Trainer Shirt Size:

Team Trainer Glove Size:

Team Member 2 Name:*

First Last

Team Member 2 Shirt Size:*

Team Member 2 Glove Size:*

Team Member 3 Name:*

First Last

Team Member 3 Shirt Size:*

Team Member 3 Glove Size:*

Do you have more than 3 team members? If so select the correct number below:*

No

Yes, we have 1 more team member

Yes, we have 2 more team members

Yes, we have 3 more team members

Yes, we have 4 more team members

Yes, we have 5 more team members

Team Member 4 Name:

First Last

Team Member 4 Shirt Size:

Team Member 4 Glove Size:

Team Member 5 Name:

First Last

Team Member 5 Shirt Size:

Team Member 5 Glove Size:

Team Member 6 Name:

First Last

Team Member 6 Shirt Size:

Team Member 6 Glove Size:

Team Member 7 Name:

First Last

Team Member 7 Shirt Size:

Team Member 7 Glove Size:

Team Member 8 Name:

First Last

Team Member 8 Shirt Size:

Team Member 8 Glove Size:

Monday Training Classes

Monday, March 4, 2024: Basic Confined Space Entry ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Monday, March 4, 2024: Basic Basic Firefighting ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Monday, March 4, 2024: Basic Vehicle Extrication ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Monday, March 4, 2024: Awareness Level Training for Hazmat ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Monday, March 4, 2024: 1 st Aid Refresher, CPR and AED Practice ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Tuesday Training Classes

Tuesday, March 5, 2024: Basic Confined Space Entry ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Tuesday, March 5, 2024: Basic Basic Firefighting ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees being Registered

Names of Attendees

Tuesday, March 5, 2024: Basic Vehicle Extrication ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees I’ll be Registering:

Names of Attendees

Tuesday, March 5, 2024: Awareness Level Training for Hazmat ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees I’ll be Registering:

Names of Attendees

Tuesday, March 5, 2024: 1 st Aid Refresher, CPR and AED Practice ($50.00 per person)

Yes, I’d like to register for this session

Class is from 6:00 am – 3:00 pm

# of Attendees I’ll be Registering:

Names of Attendees

Florida Public Safety Institute Housing

Are you interested in housing?*

Yes, I’m interested in housing

No, I am not interested in housing

Date In:*

MM slash DD slash YYYY

Date Out:*

MM slash DD slash YYYY

# of Single Rooms to Reserve ($36 per room per night):*

# of Double Rooms to Reserve ($29 per bed per night):*

Are you bringing additional guests to the Awards Banquet (includes a reception and dinner) for a fee of $30 per guest?*

Yes, I'm bringing additional guests

No, I'm not bringing additional guests

# of Additional Awards Banquet Guests*

Phone

This field is for validation purposes and should be left unchanged.

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